Diagnosesicherung, Risikostratifizierung und Therapieplanung - Bildgebende Verfahren in der Kardiologie

Die ausführliche Anamnese und die körperliche Untersuchung in Kombination mit modernen bildgebenden Verfahren gehören heutzutage zum Gesamtmanagement eines kardiologischen Patienten. Dabei spielen neuere technische Entwicklungen in der kardialen Bildgebung eine zunehmend wichtigere Rolle, sowohl zur Diagnosesicherung als auch zur Risikostratifizierung und Therapieplanung des einzelnen Patienten. Die hierbei gebräuchlichsten nicht-invasiven Verfahren mit ihren Weiterentwicklungen sollen in diesem Artikel in kurzer Form dargestellt werden.

In clinical cardiology, a careful evaluation of symptoms and the physical examination often allow a rapid identification of an underlying heart disease like an ischaemic heart disease, heart failure or the presence of cardiac arrhythmias. Nowadays, in the complex management of cardiac patients with suspected or known heart disease, various cardiac imaging methods play an essential role. In this article, several non-invasive cardiac imaging techniques as well as newer technical developments in this exciting field are presented.

Literatur

• 1 Arai A, Epstein FH, Bove KE, Wolff SD. Visualization of aortic valve leaflets using black blood MRI.  J Magn Reson Imaging. 1999;  10 771-777
• 2 Becher H, Lofiego C, Mitchell A, Timperley J. Current indications for contrast echocardiography imaging.  Eur J Echocardiogr. 2005;  6 1-5
• 3 Bellenger NG, Burgess MI, Ray SG. et al. . Comparison of left ventricular ejection fraction and volumes in heart failure by echocardiography, radionuclide ventriculography and cardiovascular magnetic resonance: are they interchangeable.  Eur Heart J. 2000;  21 1387-1396
• 4 Cheitlin MD, Armstrong WF, Aurigemma GP. et al. . ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography: summary article: a report of the America College of Cardiology/ American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASE Committee to Update the 1997 Guidelines for the Clinical Application of Echocardiography).  Circulation. 2003;  108 1146-1162
• 5 Chrysohoou C, Greenberg M, Stefanadis C. Non-invasive methods in differentiating ischaemic from non-ischaemic cardiomyopathy. A review paper.  Acta Cardiol. 2006;  61 454-462
• 6 Clark AN, Beller GA. The present role of nuclear cardiology in clinical practice.  Q J Nucl Med Mol Imaging. 2005;  49 43-58
• 7 Constantine G, Shan K, Flamm SD, Sivananthan MU. Role of MRI in clinical cardiology.  Lancet. 2004;  363 2162-2171
• 8 Davidavicius G, Kowalski M, Williams RI. et al. . Can regional strain and strain rate measurement be performed during both dobutamine and exercise echocardiography, and do regional deformation responses differ with different forms of stress testing?.  J Am Soc Echocardiogr. 2003;  16 299-308
• 9 Durack DT, Lukes AS, Bright DK. New criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findings. Duke Endocarditis Service.  Am J Med. 1994;  96 200-209
• 10 Ergun I, Keven K, Uruc I, Ekmekci Y, Canbakan B, Erden I, Karatan O. The safety of gadolinium in patients with stage 3 and 4 renal failure.  Nephrol Dial Transplant. 2006;  21 697-700
• 11 Fitzpatrick GM, Wells RG. Simulation study of respiratory-induced errors in cardiac positron emission tomography/computed tomography.  Med Phys. 2006;  33 2888-2895
• 12 Flachskamp FA, Decoodt P, Fraser AG. et al. . Working Group on Echocardiography of the European Society of Cardiology. Guidelines from the Working Group. Recommendations for performing transesophageal echocardiography.  Eur J Echocardiogr. 2001;  2 8-21
• 13 Franke A, Kuhl HP. New Imaging Methods in the Diagnosis of Mitral Regurgitation.  Herz. 2006;  31 22-29
• 14 Holland GA, Dougherry L, Carpenter JP. et al. . Breath-hold ultrafast three-dimensional gadolinium-enhanced MR angiography of the aorta and the renal and other visceral abdominal arteries.  AJR Am J Roentgenol. 1996;  166 971-981
• 15 Kim RJ, Fieno DS, Parrish TB. et al. . Relationship of MRI delayed contrast enhancement to irreversible injury, infarct age, and contractile function.  Circulation. 1999;  100 1992-2002
• 16 Laissy JP, Messin B, Varenne O. et al. . MRI of acute myocarditis: a comprehensive approach based on various imaging sequences.  Chest. 2002;  122 1638-1648
• 17 Nienaber CA, Kodolitsch Y von, Nicolas V. et al. . The diagnosis of thoracic aortic dissection by noninvasive imaging procedures.  N Engl J Med. 1993;  328 1-9
• 18 Tunick PA, Kronzon I. Atheromas of the thoracic aorta: clinical and therapeutic update.  J Am Coll Cardiol. 2000;  35 545-554
• 19 Voigt JU, Arnold MF, Karlsson M. et al. . Assessment of regional longitudinal myocardial strain rate derived from Doppler myocardial imaging indexes in normal and infarcted myocardium.  J Am Soc Echocardiogr. 2000;  13 588-598
• 20 Voigt JU, Flachskamp FA. Strain and strain rate.  Z Kardiol. 2004;  93 249-258
• 21 Wackers F, Soufer R, Zaret B. Nuclear Cardiology. In: Braunwald E et al. (Hrsg.): Heart Disease. Philadelphia: W.B. Saunders 2001

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